<br>
<div class="container">
<div class="head-top"><img src="<?php echo base_url() ?>assetx/img/logo_pzh.png"  class="img-responsive gambar-headerku" alt="Responsive image"></div>
</div>
<script type="text/javascript">
jQuery(document).ready(function(){

    jQuery("#tanggal_jam").datetimepicker({
      defaultDate:'2013/12/21',
      timepicker:true,
    mask:true,
    format:'Y/m/d',
      lang:'id'});


});
</script>
<div class="container container-bg">
<div class="row">
<div class="col-xs-6">
<img src="<?php echo base_url() ?>asseta/images/cantik.jpg"  class="img-responsive" alt="Santri Cantik">




</div>
<div class="col-xs-3"><?php echo form_open('home/aksi_transfer');?>
<!-- Konten Awal --><br><br><br>
<br>
<div class="panel panel-default">
  <div class="panel-body">

  <div class="form-group">
    <label for="Email">Nama Lengkap</label>
    <input type="text" class="form-control" id="Email" placeholder="ex: Nama Lengkap" name="nama_lengkap">
  </div>
  <div class="form-group">
    <label for="exampleInputPassword1">Nama Bank</label>
    <input type="text" class="form-control" id="exampleInputPassword1" placeholder="ex: Bank Mandiri" name="refrensi">
  </div>
  <div class="form-group">
    <label for="exampleInputPassword1">No Rekening</label>
    <input type="text" class="form-control" id="exampleInputPassword1" placeholder="ex: 9393939393" name="refrensi">
  </div>
    <div class="form-group">
    <label for="exampleInputPassword1">Transfer ke</label>
    <select class="form-control" name="bank">
  <option value="Mandiri">Mandiri : 98659849887</option>
  <option value="Danamon">Danamon : 98659849887</option>
  <option value="Permata">Permata : 98633849887</option>

</select>
  </div>
    <div class="form-group">
    <label for="exampleInputPassword1">Tanggal Transfer</label>
    <input type="text" class="form-control" id="tanggal_jam" placeholder="" name="tanggal_jam">
  </div>
  <button type="submit" class="btn btn-default">Kirim</button>
  <?php echo form_close(); ?>

  </div>
</div>
<!-- Konten Akhir -->
</div>
<div class="col-xs-3">
<br><br><br><br><br><br><br><br>
<blockquote class="blockquote-reverse">
  <p>Gunakan Email dan No Refrensi Pendaftaran Sebagai Kredensial Login ke Sistem</p>
  <footer>Belum Mendaftar? <cite title="Source Title"><a href="<?php echo base_url() ?>home/santri_daftar">Daftar di Sini</a></cite></footer>
</blockquote>

</div>
</div>
</div><br><br>